末端可弯负压吸引鞘联合输尿管软镜碎石术治疗肾结石的疗效观察  

Efficacy of retrograde intrarenal surgery using a flexible-tip negative pressure ureteral access sheath for the treatment of renal stones

作　　者：朱进[1] 刘康 周毅彬[1] 薛波新[1] 阳东荣[1] Zhu Jin;Liu Kang;Zhou Yibin;Xue Boxin;Yang Dongrong(Department of Urology,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院泌尿外科,苏州215004

出　　处：《微创泌尿外科杂志》2024年第5期308-312,共5页Journal of Minimally Invasive Urology

摘　　要：目的:评估末端可弯负压吸引鞘应用于输尿管软镜碎石术治疗肾结石的疗效和安全性。方法:回顾性分析2023年2月至9月苏州大学附属第二医院收治的80例肾结石患者,根据手术方式的不同分为对照组(n=40)和联合组(n=40)。对照组采用传统输尿管软镜碎石治疗,联合组采用末端可弯负压吸引鞘联合输尿管软镜碎石。比较两组手术时间、术后住院时间、清石率、术后血尿持续时间、术后感染发生率、其他并发症情况。结果:手术均获得成功。两组手术时间、术后住院时间比较差异无统计学意义(P>0.05)。联合组术后即刻清石率、术后1个月清石率分别为82.5%(32/40)、95%(38/40),高于对照组的10%(4/40)、72.5%(29/40),差异均有统计学意义(P<0.05)。联合组术后平均血尿持续时间[(5.60±2.91)d]短于对照组[(8.30±3.37)d],术后感染发生率(2.5%,1/40)低于对照组(17.5%,7/40),差异均有统计学意义(P<0.05),对照组1例尿源性脓毒血症患者经对症治疗好转。两组均无严重血尿、肾血肿、输尿管穿孔、输尿管撕脱等并发症发生。结论:末端可弯负压吸引鞘联合输尿管软镜治疗肾结石安全有效、清石率更高,术后感染发生率更低。Objective:To evaluate the efficacy and safety of retrograde intrarenal surgery(RIRS)using a flexi-ble-tip negative pressure ureteral access sheath(UAS)for the treatment of renal stones.Methods:From February 2023 to September 2023,80 cases of kidney stones in the Second Affiliated Hospital of Suzhou University were divid-ed into control group(n=40)and combined group(n=40)by different surgrey methods.The control group were treated with traditional RIRS,and the combined group were treated with RIRS using the flexible-tip negative pres-sure UAS.The operation time,postoperative hospital stay,stone clearance rate,postoperative hematuria duration,postoperative infection rate and other complications were compared.Results:All procedures were successful.There was no significant difference of operation time or postoperative hospital stay between the two groups(P>0.05).The immediate and one-month stone clearance rate were 82.5%(32/40)and 95%(38/40)in the combined group,respec-tively,which were significantly higher than 10%(4/40)and 72.5%(29/40)in the control group(P<0.05).In the combination group,the postoperative hematuria duration[(5.60±2.91)d]was significantly shorter than that in the control group[(8.3±3.37)d],the incidence of postoperative infection(2.5%,1/40)was significantly lower than that in the control group(17.5%,7/40),the differences were statistically significant(P<0.05).There was one case of urosepsis in the control group,which was cured by systematic treatment.No other severe complications such as se-vere bleeding,renal hematoma,perforation or avulsion of ureter occurred.Conclusion:RIRS using flexible-tip nega-tive pressure UAS,in combination with ureteroscopic lithotripsy is a safe and effective treatment for renal stones,pro-viding a higher stone clearance rate and a lower postoperative infection rate.

关 键 词：肾结石 末端可弯负压吸引鞘 输尿管软镜碎石术 

分 类 号：R693.4[医药卫生—泌尿科学]